July 28, 2014

Decade #2

This month I crossed the line into my second decade of blogging -- I started posting musings on the web on July 1, 2004.

That was a long time ago.

That month I was busy getting ready for the lactation consultant certification exam, which I took for the second time today. It was harder than I remembered. I have been looking up answers since I got home, wondering what the Google algorithm is going to make of my searches for "nipple + [specific type of lesion]" and "breastfeeding + [specific drug of abuse]." We won't even talk about the breast surgery searches, mostly because I signed a non-disclosure agreement. But I can hardly wait to see what will supplant the Modcloth ads that have been showing up in my sidebars lately.

I am wrapping up my preparation for the lactation consultant certification exam. Monday morning I will head to a hospital in a tough part of town where from nine until four I will answer multiple-choice questions about breastfeeding. Ugh ugh ugh I hope I pass.

When I was in school I always had good intentions about studying for my exams well in advance, with a keenly focused mind and an eagle eye for important details. I always got distracted. By the length of my toenails. By my failure to answer a letter. By my need to figure out the guitar part for that cool song playing on the stereo (ostensibly "to help me study") immediately. Thankfully I'm a good test-taker.

At least I used to be a good test-taker. I'm anxious about this one. So why oh why, if I'm worried about failing, have I been such a goof about studying for it?

Today I have been trying to cram some last shreds of knowledge into my head but I have been badly distracted. I have been trying to remember that FIL stands for feedback inhibitor of lactation while PIF is prolactin-inhibiting factor. But really I have been thinking about Nigella Lawson's supermarket.

Nigella Lawson is forever saying, of obscure items in her lengthy ingredient lists, "Oh, I buy this at the supermarket." Sambal oelek,* lemongrass, Thai holy basil -- it's all there.

I pull myself back to the task at hand. Prolactin is secreted from the anterior pituitary; oxytocin from the posterior. When milk is removed from the breast, the hypothalamus inhibits the release of dopamine, stimulating the release of prolactin and causing milk produc.....

...Our supermarket in the UK was a tiny place whose powers-that-were deemed decaf coffee and Parmesan cheese too exotic to stock regularly. There was no whole-wheat flour. And yet Nigella's supermarket keeps za'atar** and halloumi*** on its shelves. What gives?

MUST. GET. GRIP. Lymphocytes constitute the remaining 10 percent of white cells in the milk. About 20 percent of these cells are B lymphocytes, which give rise to antibodies; the rest are T lymphocytes, which kill infected cells directly or send out chemical messages that mobilize still other components of the immune system. Milk lymphocytes seem to behave differently from blood lymphocytes. Those in milk, for example, proliferate in the presence of Escherichia coli, a bacterium that can cause life-threatening illness in babies, but they are far less responsive than blood lymphocytes to agents posing less threat to infants.****

...I know some of it is a US-UK difference. In our little supermarket with no bagels and no cream cheese I could always buy ground almonds and marzipan for baking. I could find Seville oranges and red currant jelly. But white raspberries? white currants? white peaches? Holy galangal, Batman -- where is this place, with its albino produce and its endless spice aisle? Imagine popping in to get something quick for dinner and emerging laden with game stock and lavender flowers and shrimp paste (not to be used in the same recipe. Or at least not yet. Who knows what Nigella's next cookbook will offer as a follow-up to Slut-Red Raspberries in Chardonnay Jelly?).

Perhaps chardonnay jelly is the stuff of which my brain is made, because I have slogged through most of the chapter on breast pumps in Jan Riordan's Breastfeeding and Human Lactation and I cannot make sense of this bit: A pump does not pump, suck, or pull milk out of the breast. It reduces resistance to milk outflow from the alveoli, allowing the internal pressure of the breast to push out the milk. What does that mean? I thought if I read it enough times I would understand, but at this point I am thinking that if there is no pumping, sucking, or pulling, it must mean that the Milk Fairy waves her wand at the breasts and milk is magically ejected.

I wonder if the Milk Fairy works second shift at Nigella Lawson's supermarket. Maybe she supervises the production of the mascarpone cheese and the French butter, the creme fraiche and the Greek yogurt. I wish that in between jobs she could sprinkle some fairy dust on that breast pump chapter to render it just slightly more intelligible, but I know she's a busy gal.

I had hoped that in the years since my last big test I would have become more mature and purposeful, less distractible and flighty. Apparently not, though, because a mature non-flighty person would never ask the question to which I am led inexorably by my intersecting trains of thought*****: does this supermarket, where quinces and quail's eggs nestle cheek by jowl with eaux de vie and orange oil (Boyajian, please) -- does it have breastmilk on its shelves? Because that -- that would be a memorable supermarket.

*Indonesian chili paste, found hidden deep in Chinatown **Middle Eastern spice blend comprising sumac, thyme, and sesame seeds, tracked down at Penzey's ***Cypriot cheese made of sheep and goat milk, available at Whole Foods for the low low price of one arm + one leg (per pound) ****from a 1995 Scientific American article by Jack Newman, reprinted here *****if you have intersecting trains of thought, does that make your mind a train wreck?